Functional & Applied Anatomy of the Hip Joint

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Questions and Answers

What is a primary characteristic of osteoarthritic hips?

  • Joint inflammation is the main cause of pain
  • Grinding bone surfaces cause mechanical pain (correct)
  • Joint space is widened and smooth
  • Cartilage cushion is thicker than normal

What is the main initial site of damage in rheumatoid arthritis?

  • The bone surrounding the joint
  • The ligaments supporting the joint
  • The joint cartilage itself
  • The synovium surrounding the joint (correct)

What is a common cause of osteonecrosis in children aged 3 to 9?

  • Genetic predisposition to bone diseases
  • Injury to the knee joint
  • Disruption of blood supply to the femoral head (correct)
  • Severe inflammation of the synovium

How does osteonecrosis affect the femoral head?

<p>It becomes irregular in shape due to collapse (C)</p> Signup and view all the answers

What happens to joint cartilage in advanced rheumatoid arthritis?

<p>It is destroyed, leading to damage in adjacent bone (B)</p> Signup and view all the answers

What is the primary cause of pain in the early stages of arthritis?

<p>Inflammation in the synovium (B)</p> Signup and view all the answers

Which bursa is the largest in the hip region?

<p>Trochanteric bursa (D)</p> Signup and view all the answers

What condition may occur due to inflammation of the trochanteric bursa?

<p>Trochanteric bursitis (A)</p> Signup and view all the answers

Which bursa communicates with the cavity of the hip joint?

<p>Iliopectineal bursa (A)</p> Signup and view all the answers

What characterizes osteoarthritis in relation to joint cartilage?

<p>Progressive damage to cartilage (D)</p> Signup and view all the answers

Which bursa could become inflamed due to friction from activities like biking?

<p>Ischiogluteal bursa (A)</p> Signup and view all the answers

What results from the development of bony spurs in osteoarthritis?

<p>Restricted joint movement (C)</p> Signup and view all the answers

During which stage of arthritis does the pain primarily arise from mechanical friction?

<p>Late stage (D)</p> Signup and view all the answers

Which of the following statements about hip replacement is true?

<p>It effectively treats avascular necrosis (B)</p> Signup and view all the answers

What primarily causes inflammation in arthritis?

<p>Immune system response (C)</p> Signup and view all the answers

What type of joint is the hip joint classified as?

<p>Ball and socket joint (C)</p> Signup and view all the answers

What is the primary function of the iliofemoral ligament?

<p>Prevents hyperextension of the hip (B)</p> Signup and view all the answers

Which muscle is primarily responsible for hip flexion?

<p>Iliopsoas (A)</p> Signup and view all the answers

Which of the following types of fractures is commonly associated with the femoral neck?

<p>Intracapsular fractures (A)</p> Signup and view all the answers

What condition is characterized by an inability to abduct the thigh due to a shallow acetabulum?

<p>Congenital hip dislocation (C)</p> Signup and view all the answers

What is a common result of posterior hip dislocation?

<p>Medial rotation and shortening of the affected limb (C)</p> Signup and view all the answers

What arteries are primarily responsible for supplying the femoral head?

<p>Profunda femoris and medial circumflex arteries (D)</p> Signup and view all the answers

What type of arthritis is commonly associated with the hip joint?

<p>Both osteoarthritis and rheumatoid arthritis (B)</p> Signup and view all the answers

What is the most significant consequence of femoral neck fractures?

<p>Disruption of blood supply to the femoral head (B)</p> Signup and view all the answers

What is the primary role of the transverse acetabular ligament?

<p>Provides stability to the joint (D)</p> Signup and view all the answers

Which nerve is NOT involved in the innervation of the hip joint?

<p>Musculocutaneous nerve (B)</p> Signup and view all the answers

Which of the following ligaments helps prevent hyperabduction of the hip?

<p>Pubofemoral ligament (A)</p> Signup and view all the answers

What is the role of the ligament of the head of the femur?

<p>Serves as a blood supply conduit to the femoral head (C)</p> Signup and view all the answers

Flashcards

Osteoarthritis of the Hip

A type of arthritis that affects the hip, characterized by thin cartilage, bare spots on bone, and grinding causing mechanical pain.

Osteonecrosis of the Hip

A condition where the femoral head (top of the thigh bone) dies, causing pain and collapse due to the inability of the dead bone to withstand weight.

Rheumatoid Arthritis of the Hip

A form of arthritis that mainly affects the synovium (joint lining) and leads to destruction of cartilage and surrounding bone.

Narrowed Joint Space in the Hip

The narrowed and irregular joint space in the hip can lead to osteoarthritis.

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Post-Traumatic Avascular Necrosis of the Hip

A condition in children where the blood supply to the femoral head is disrupted, leading to the death of the bone.

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Avascular

Lacking blood vessels. Particularly relevant in the context of bone healing, as this means damaged tissue may not receive adequate blood supply for repair.

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Necrosis

The death of cells and tissues due to lack of blood supply.

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Hip Replacement

A surgical procedure to replace a damaged hip joint with an artificial one. It involves implanting a prosthetic joint to restore mobility and reduce pain.

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Extracapsular

Located outside the joint capsule, referring to a hip fracture.

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Intracapsular

Located within the joint capsule, referring to a hip fracture.

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Bursa

A fluid-filled sac that reduces friction between bones, muscles, and tendons. There are several important bursae around the hip joint.

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Trochanteric Bursitis

Inflammation of the trochanteric bursa, a fluid-filled sac near the hip bone. It often causes pain and tenderness around the hip.

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Arthritis

Inflammation of a joint, often caused by damage to the cartilage. It's characterized by pain, stiffness, and decreased mobility.

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Osteoarthritis

The most common type of arthritis, characterized by the breakdown of cartilage in joints, leading to pain and stiffness.

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Osteophytes

Bony spurs (osteophytes) that develop on the edge of joints in osteoarthritis. They can restrict movement.

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What type of joint is the hip joint?

The hip joint is known as a 'ball and socket' synovial joint. This means it allows for a wide range of movement in different directions, similar to a ball fitting into a socket. However, this mobility comes at the cost of some stability.

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Describe the acetabulum and its function.

The acetabulum is a deep, cup-shaped socket on the hip bone (innominate bone) that receives the head of the femur. This deep fit contributes to the hip joint's stability.

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What is the role of the femoral head?

The head of the femur (thigh bone) is a smooth, rounded ball that fits into the acetabulum. It is responsible for providing the ball-like component of the hip joint.

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What is the femoral neck and why is it important?

The femoral neck connects the femoral head to the femoral shaft (the main part of the thigh bone). It's a narrow area that is often the site of fracture, especially in elderly individuals.

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What is the iliofemoral ligament and its role?

The iliofemoral ligament is the strongest ligament in the body. It helps stabilize the hip joint by preventing excessive movement, particularly hyperextension. In standing, it keeps the femoral head firmly seated in the acetabulum.

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What is the pubofemoral ligament and its role?

The pubofemoral ligament reinforces the inferior and anterior aspect of the hip joint, assisting in preventing hyperabduction (excessive outward movement) of the hip.

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What is the ischiofemoral ligament and its role?

The ischiofemoral ligament helps to prevent hyper-extension of the hip and supports the posterior part of the joint. It works to pull the femoral head into the acetabulum.

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What is the iliopsoas muscle and its function?

The iliopsoas muscle is a powerful flexor of the hip, responsible for bending the hip forward. It also helps to externally rotate the hip.

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What is the gluteus maximus muscle and its function?

The gluteus maximus is the largest muscle in the body and a powerful extensor of the hip. It helps to straighten the leg backwards and also assists in external rotation.

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What are the gluteus medius and minimus muscles and their function?

The gluteus medius and minimus are responsible for abducting the hip (moving the leg away from the body). They also help in internal rotation.

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What are the major nerves that supply the hip joint and their function?

The superior gluteal nerve supplies muscles that abduct and laterally rotate the thigh, while the inferior gluteal nerve innervates muscles that extend the hip.

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What are the main blood supply to the femoral head?

The lateral and medial circumflex arteries are the main supply to the femoral head, travelling within the fibrous capsule of the hip joint. These arteries may be damaged in fractures of the femoral neck.

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What is a hip dislocation?

A common issue that can occur at the hip joint. It describes the complete separation of the femoral head from the acetabulum. It can be caused by trauma or congenital factors.

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What is a femoral neck fracture?

A type of hip fracture that occurs within the capsule of the hip joint. It is a common injury in older adults due to weakened bones.

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What is a trochanteric fracture?

This type of hip fracture happens outside of the hip joint's capsule, usually affecting the trochanters (bumps on the thigh bone). This is a less serious fracture than a femoral neck fracture.

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What types of arthritis affect the hip joint?

Osteoarthritis, a degenerative joint disease, is a common cause of hip pain. It involves gradual damage to the cartilage lining the joint surfaces. Rheumatoid arthritis is an autoimmune disease that can also affect the hip joint.

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Study Notes

Functional & Applied Anatomy of the Hip Joint

  • The hip joint is a ball-and-socket synovial joint.
  • It supports body weight and is crucial for locomotion.
  • The head of the femur fits deeply into the acetabulum, a deep socket in the pelvic bone.
  • This deep insertion yields a wide range of movement but sacrifices some stability.
  • Strong & stable construction of the hip joint; a substantial force needed to cause injury.
  • Major trauma can result in dislocation, fracture, and damage to joint surfaces and related structures.

Pelvic Girdle

  • The pelvic girdle comprises three bones: ilium, ischium, and pubis.
  • These bones fuse to form the innominate (hip) bone.
  • The acetabulum is formed by the fusion of these three bones.

Proximal Femur Anatomy

  • The proximal femur includes the femoral head, neck, greater trochanter, and lesser trochanter.
  • The femoral neck is a common site of fracture.
  • The intertrochanteric crest is another site of fracture.

Acetabulum Anatomy

  • The acetabulum is a cup-shaped socket on the pelvic bone.
  • Fibrocartilage, also known as the acetabular labrum, deepens the socket and adds stability.
  • The acetabular fossa is a depression in the acetabulum,
  • The acetabular foramen is a hole in the acetabulum.
  • There's a transverse acetabular ligament and other supporting ligaments & structures that help maintain stability.

Articular Capsule & Ligaments

  • The strong & dense articular capsule is attached around the acetabulum and the femoral head.
  • Strong reinforcing ligaments (iliofemoral, ischiofemoral, and pubofemoral) stabilize the joint and limit excessive movement.

Capsular Ligaments

  • The iliofemoral ligament is the most potent and stabilises the hip in the upright position.
  • The pubofemoral and ischiofemoral ligaments limit movements like hyperextension and hyperabduction.

Major Movements by Muscles

  • Hip movements are facilitated by various muscle groups.
  • Flexors: iliopsoas, rectus femoris, sartorius, tensor fasciae latae
  • Adductors: adductor magnus, adductor longus, gracilis
  • Extensors: gluteus maximus, biceps femoris, hamstring muscles.
  • Lateral rotators: piriformis, superior gemellus, inferior gemellus, quadratus femoris
  • Abductors: gluteus maximus, gluteus medius, gluteus minimus

Nerve Supply

  • The femoral nerve (L2, L3, L4) and obturator nerve (L2, L3, L4) innervate the structures in the hip region.
  • The superior gluteal nerve & sciatic nerve also are important players in innervation.

Blood Supply

  • The hip joint receives blood from the medial and lateral circumflex femoral arteries, the obturator artery, and the deep artery of the thigh.
  • These arteries supply the femoral head and neck to ensure blood flow to the important ligaments and bones in the joint.

Common Disorders

  • Hip dislocations (congenital or acquired).
  • Femoral neck fractures.
  • Trochanteric fractures.
  • Bursitis.
  • Arthritis (osteoarthritis or rheumatoid arthritis).
  • Osteonecrosis.

Hip Dislocations (Congenital)

  • Congenital hip dislocations (CDH) are relatively common, with a higher occurrence in females.
  • Factors can include shallow acetabulum or improper positioning of the femoral head within the acetabulum.

Hip Dislocations (Acquired)

  • Acquired hip dislocations are uncommon because of strong and stable articulation.
  • A forceful collision or trauma, especially during a car accident where the knee hits the dashboard, can force the femur posteriorly.

Femoral Neck Fractures

  • Disruption to the blood supply to the head of the femur can lead to serious issues.
  • Common in older adults due to weakened bones from osteoporosis.
  • Trauma from impacts (especially in young individuals) can cause fractures.

Hip Replacements

  • Some cases necessitate hip replacement surgeries.

Hip Bursae

  • Several bursae surrounding the hip joint play vital roles in reducing friction and absorbing shock. Key bursae include trochanteric bursa, iliopectineal bursa, and ischiogluteal bursa, and they can become inflamed leading to bursitis conditions.

Hip Joint Disease

  • Arthritis (inflammation of the joint) involves damage to cartilage and is common in the hip region.
  • Osteoarthritis involves bony spurs (osteophytes), cartilage damage, and a narrowed joint space.
  • Rheumatoid arthritis starts in the synovium and leads to damage of bone and cartilage.
  • Osteonecrosis is a disease caused by blood loss to the femoral head, leading to its demise.

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